In Module One, we discussed the importance of quality within our health
care system. We discussed the notion that it is very difficult to define
quality, as it certainly differs based on perspective. Nevertheless, from a
global perspective, we can look at quality from a standpoint of life
expectancy. It could be argued that if quality services were delivered, our
population would live longer than those without quality services. In terms of
the United States, we certainly do not have the highest life expectancy.
There are numerous countries where the population does indeed live longer
and has a greater level of overall health service delivery. Why then does the
United States lag behind? Where are our shortcomings in terms of the
global benchmark? To answer these questions, we must first develop an
understanding of the triangle of health care: quality, cost, and access.
The United States spends more on health care than any other industrialized
nation. It is also the only industrialized nation without a universal health
plan. Granted, the Affordable Care Act of 2010 was a large piece of
legislation; however, it certainly is not universal health coverage. If you
recall, in Module One, it was mentioned that the annual price tag on health
care in the United States is a whopping 2.6 trillion dollars. Trillion is such an
incredibly large number that only astronomers and politicians use it. Imagine
you had a stack of $100 dollar bills laying one on top of the other. At 3.5
feet, we are at a million dollars. At 3,500 feet, we are at a billion dollars; this
is as tall as a 10-story office building. Now, to get to a trillion dollars, we
need 1,000 ten-story buildings on top of each other. This would be the
equivalent of 712 miles. The United States spends 2.6 trillion dollars; this is
a stack of 100 dollar bills reaching 1,851 miles, which would be the distance
from Los Angeles to New Orleans. That is a lot of money!
While we spend more than any other country in the world on health care,
we have a very large number of individuals without health coverage. It is
difficult to truly ascertain just how many individuals do not have insurance;
however, a fair estimation is roughly 48 million Americans without health
coverage. Again, for perspective’s sake, 48 million would be the entire
populations of California, Arizona, and Colorado. In terms of access, those
48 million Americans do not have access to primary care physicians. As a
result, those uninsured often forego the most basic of health care services,
including immunizations. A resurgence of some of the diseases once
thought eradicated on U.S. soil has fueled the debate of universal coverage
once again. In this week’s readings, you will find that it is estimated that an
average of $36 per person per month is all that would be required to
increase our access to fundamental health services for every citizen. It is
argued that access to basic health services would save money in the long
run. Proponents of this suggest that individuals without insurance often
wait until their situation is critical or utilize emergency rooms at a much
higher rate than those with insurance.
In the idea of the triangle of health care delivery, any moving of one side
ultimately affects the other two. If we had unlimited dollars to invest in
health care, access and quality would increase accordingly. As such, the
readings for this week focus on access and its impact on quality and overall
cost.
Reference
Stephens, J. H., & Ledlow, G. R. (2010). Real healthcare reform: Focus on
primary care access. Hospital Topics, 88(4). 98-106.
